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General NPI Number Information
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NPI Number | 1962147280
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Entity Type | Individual
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Provider Name | ELIZABETH REED FOX DDS
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Gender | Female
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Dates
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Enumeration Date | 05/02/2022
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Last Update Date | 02/29/2024
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Provider Practice Location Address
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Address Line | 11 MAGNOLIA CV DR
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City | SIMPSONVILLE
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State | SC
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Zip | 29680
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Country | US
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Telephone | 864-841-8062
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Fax |
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Provider Business Mailing Address
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Address Line | 7735 SW 11TH PLACE
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City | GAINESVILLE
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State | FL
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Zip | 32607
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Country | US
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Telephone | 352-265-0111
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DGD.10704
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License Number State | SC
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DN27663
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | DRPM2445
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License Number State | FL
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Taxonomy #4
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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